Some sites of metastases are worse than others

Impact of single-site distant metastases on prognosis in advanced ovarian cancer: a Surveillance, Epidemiology, and End Results population-based study

https://tinyurl.com/4neetm9k

In general, the presence of a distant metastasis is a bad prognostic indicator for women with ovarian cancer. The 5-year survival rate for these women is about 30%.

Distant metastases may occur in the liver, lungs, bones or brain. This study looks at the different survival outcomes for each site. Using the SEER database, which collects cancer information from the US population, the overall survival for 639 patients was determined.

From the information collected the most likely site of distant metastasis is in the liver which was seen in about half of the group. Next the lungs (40%), bones (5%) and brain (1%).

Survival for all these patients is affected. The least impact is seen for those women with liver disease, which has significantly better survival than other distant metastasis sites. This knowledge may help to determine appropriate management of this grave complication of ovarian cancer.

Cancelled RCTs

Characteristics and potential predictors of prematurely terminated interventional clinical trials for ovarian cancer in the ClinicalTrials.gov database

https://tinyurl.com/55efrnfz

Many randomised clinical trials (RCT) do not reach their endpoint with about 25% being terminated for various reasons. This study used data from the Clinical Trials.gov website to discover whether this is true for ovarian cancer also.

The website records all clinical trials recruiting in the US and World-wide, a listing on this site does not require FDA or NIH approval. During the period 2003-2022 1420 RCTs for ovarian cancer were included.

Of these, 21% were terminated early. Mostly this was a result of logistic issues such as recruitment or funding. About 1/5th of the terminations was due to the intervention being non-effective.

The RCTs most likely to be terminated tended to be larger trials requiring big numbers of participants and were more likely when the trial was phase 2. A trial involving multiple large centres of care was most likely to be successfully completed.

Misinformation may cause distress

Quarter of all ovarian cancer cases linked to endometriosis: expert

https://tinyurl.com/vch9rrc9

NewsNation a cable network news service is the leader in US prime-time television being the most-watched service. As such it has a responsibility to ensure that any comment is factual and correct.

A recent posting stating that 25% of ovarian cancer is associated with endometriosis does not meet this benchmark. Information taken from a large cohort study published in JAMA in July 2024 appears to have been misinterpreted or misunderstood.

Endometriosis is associated with ovarian cancer, most notably rare types such as endometrioid and clear cell cancer, which most often present at an early stage. The cohort study shows the greatly increased risk with infiltrative and ovarian endometrioma type disease. However, these represent only a very small proportion of the total spectrum of endometriosis.

The absolute risk of developing ovarian cancer for women with endometriosis is about 2%. Most research suggests about 10 % of all ovarian cancer has some link to endometriosis. To state otherwise in such a public forum may cause unnecessary distress.